LB 

34-03 







Class_L/2L3A 
Book _JAJJl 



UNITED STATES PUBLIC HEALTH SERVICE 



SCHOOL HYGIENE 

REPORT OF THE MEETING OF THE FOURTH INTER- 

NATIONAL CONGRESS ON SCHOOL HYGIENE 

BUFFALO, N. Y., AUGUST 25-30, 1913 



BY 



J. W. SCHERESCHEWSKY 

Surgeon 
United States Public Health Service 



REPRINT No. 144 

PROM THE 

PUBLIC HEALTH REPORTS 

October 3, 1913 




WASHINGTON 

GOVERNMENT PRINTING OFFICE 

1913 



Wonograph 



/ 



SCHOOL HYGIENE. 1 

REPORT OF THE MEETING OF THE FOURTH INTERNATIONAL CONGRESS ON SCHOOL 
HYGIENE, BUFFALO, N. Y„ AUGUST 25-30. 1913. 

By J. W. Scheeesche-wsky, Surgeon, United States Public Health Service. 

The Fourth International Congress on School Hygiene met in 
Buffalo from August 25 to August 30, 1913. Some 2,000 Americans, 
interested in various phases of school hygiene, were present at the 
section meetings. 

The congress was divided into the following sections: 

Section 1. The hygiene of school buildings, grounds, material, 
equipment, and upkeep. 

Section 2. The hygiene of school administration, curriculum, and 
schedule. 

Section 3. Medical, hygienic, and sanitary supervision in schools. 

Mental Hygiene. 

There was one feature which aroused much interest. This was the 
discussion of the importance of mental hygiene and the necessity of 
ordering mental education in children, not only with a view to develop- 
ing their mentality to the point of greatest working efficiency, but 
also to secure their perfect adjustment on the intellectual level deter- 
mined by their respective innate capacities. 

There can be no question that we have laid too much emphasis in 
the past upon the influence of bodily defects only in the develop- 
ment of children, and have lost sight of the influence of imperfect 
states of mental adjustment of the organism to the environment — 
conditions productive of mental instability and disease. 

At present our data are both incomplete and imperfect so far as 
they go. Much study will be required before we shall be able cor- 
rectly to evaluate children, both in respect to their inherited mental 
capacity and their tendency to mental disease. 

Moreover, the influence of environment and the ways in which it 
reacts adversely upon the mechanisms of mental adjustment require 
intensive study before useful data can be collected. 

Reprint from the Public Health Reports, \ r ol. XXVIII, No. 40, October 3, 1913. 
12552°-13 (2031) 



■' 



October 3, 1913 2032 

When, at length, we shall be in possession of such data, the vari- 
ous papers presented in this section indicated that we shall be in a 
position not only to educate the individual child to the maximum 
efficiency in that intellectual level to which he belongs but also by 
reason of the correct adjustment of his organism to his environ- 
ment he will be free from the various strains due to inhibition, 
repression, etc., which react adversely upon the state of mental health. 

It was predicted that when the data above referred to had been 
secured great changes, amounting to a revolution, would take plaor 
in our educational methods. It was also hinted that such revolu- 
tion would be accompanied by a large increase in the funds spent 
for educational purposes. Great stress was laid on the value of 
pschyopathic clinics as aids in securing the required data, and the 
necessity of having such clinics for the study of school children was 
referred to. 

The Bine t- Simon Scale. 

Of interest in this connection was the symposium held on Friday, 
August 29, on the Binet-Simon scale for determining the intelligence, 

A number of interesting papers were presented. Among them 
were papers by Prof. W. H. Pyles on "The value to be derived from 
giving mental tests to all school children; by Josiah Morse, of the 
University of South Carolina, on "A comparison of white and colored 
school children, measured by the Binet-Simon scale of mental intel- 
ligence;" and by Lewis M. Terman, associate professor of education, 
Leland Stanford Junior University, Stanford, Cal., on "Revision of 
the Binet scale." 

Dr. Morse's paper showed, generally speaking, that a greater pro- 
portion of white city children passed the Binet-Simon tests in the 
higher grades. On the other hand, a comparison between city col- 
ored children and white children in mill villages showed no great 
differences in their respective intelligences. Dr Morse admitted, 
in view of these results, that there must be an environmental, apart 
from a racial, factor. 

It seems to the writer that it is of importance, in Southern States, 
where such tests are conducted, to determine the rate of hookworm 
infection in both races. It is to be expected, on the whole, that 
colored city children would show a higher rate of hookworm infec- 
tion than white city children. This would be significant in view of 
the adverse influence of hookworm infection upon mental develop- 
ment. 

The general concensus of opinion of the symposium was to the 
effect that the Binet-Simon scale was satisfactory as a means of 
grouping children in the lower school grades with respect to their 
mental development. The scale, however, was thought to be defeo 



2033 October 3, 1913 

live in the higher tests for classifying older children and adults. 
Some stress was laid on the changes in intellectual activity caused 
by the advent of puberty. It was held that birth of sex instincts 
Was accompanied not with a general rise in level of mentality but 
with a radiation of mental activity, fanwise, along a variety of differ- 
ent channels. 

It seems to the writer that there was a general misconception in 
this symposium of what the scale devised by Binet and Simon really 
is. The majority seemed to consider this scale to be a measure of the 
intellectual capacities. By its correct use, they thought, children 
could be sorted according to their innate mental abilities. 

This is a misconception of the Binet scale arising, it is thought, by 
reason of a difference in the connotation of the word "intelligence" 
in French and English. In French the primary significance of this 
word is "mentality" and not intellectual excellence. Binet himself 
is not quite definite as to the precise connotation he gives to the 
Word, but uses it in a way more significant of "degree of mental 
development" than of other meanings. 

A great number of our educators, however, seem to use "intelli- 
gence" synonymously with "intellectual excellence." 

Yet it would seem to the writer that the Binet scale is by no 
means a measure of intellectual capacity but rather one of mental 
maturity or of the intellectual level which has been attained, for 
mental growth is characterized by the attainment of successive 
levels, while intellectual capacity seems to be the ability to form 
numerous associations on the intellectual planes as they are attained. 
Binet's studies were mainly directed along the lines of determining 
at what average ages children attain these successive levels, and his 
tests are mainly devised to test if the levels in question have actually 
been attained. 

We have thus, in his system, a measure of mental maturity. If 
it is desired, however, to discover the degree of perfection of mental 
activity within the content of the several intellectual levels, special 
studies must be undertaken and special tests devised in order to 
attain precise results. 

These inadequacies of the Binet scale, however, by no means invali- 
date its findings as a means of comparison between the state of 
physical development, age, and mental maturity, nor do they diminish 
its usefulness in determining degrees of mental retardation. 

Sex Hygiene. 

Another phase of hygiene to which great prominence was given 
in the congress was that of sex hygiene. The open meeting held on 
this subject Wednesday afternoon, August 27, at Elm wood Music 
Hall was attended by the largest gathering of the congress. 



October 3, 1913 2034 

A most able and scholarly paper was presented by ex-President 
Eliot, president of the congress and chairman of this section. This 
paper constituted an admirable summing up of the subject. The 
speaker recognized that no sudden improvement in sex conditions, 
the prevalence of venereal diseases, and morality could ever be ob- 
tained. The improvement must be gradual and the results secured 
by a combination of measures. No one specific remedy could be suc- 
cessful. Segregation and the teachings of the church have both been 
tried without avail. The speaker thought that the general diffusion 
of knowledge, the requirement of certificates of health as a prelim- 
inary to marriage, the segregation of criminals and defectives, greater 
simplicity, a greater attention to physical exercise in the lives of 
growing girls and boys, and instruction in the public schools, all com- 
bined, would, in the end, effect satisfactory results. 

The general sense of the section was that the facts of reproduction 
and sex hygiene should be taught in the public schools by graded 
lectures. 

Illumination of Schoolrooms. 

It seemed to the writer that one of the most interesting and valu- 
able sections of the congress was devoted to the consideration of this 
topic. Nevertheless, the attendance was poor. 

One of the important questions discussed was that of overhead versus 
lateral illumination. One great objection to overhead illumination 
in the past has been the ocular fatigue induced by the excessive glare 
from white or polished surfaces reflected directly upward into the 
eyes from an unaccustomed direction. The absence of this condition 
in lateral illumination from the left has led to the general advocacy 
of this form of illumination. On the other hand, owing to the fact 
that illumination falls off in proportion to the square of the distance, 
laterally illuminated rooms are insufficiently illuminated on the ex- 
treme right when the lighting at the left is sufficient. On the other 
hand, with sufficient illumination on the right of the room, the seats 
on the left are likely to have an excess. 

The overhead method of illumination, however, can be made satis- 
factory by means of ribbed glass, which diffuses the light in angular 
directions. This prevents undue upward reflections from white 
and polished surfaces. 

The pernicious influence of glare from calendered paper and black- 
boards was also emphasized. Light-colored, mat-surface blackboards 
and cream-colored unglazed papers were advocated. Dr. Gstettner, 
of Vienna, pointed out the loss of illumination in schoolrooms caused 
from light absorption by the black surface of blackboards and showed, 
from the results of photometric measurements, the improvement in 



2035 October 3, 1913 

lighting conditions following the use of light-colored blackboards and 
dark crayons. 

An interesting paper on the extent of loss of ocular efficiency in 
direct, semidirect, and indirect systems of artificial illumination was 
read by Prof. Ferree, of Bryn Mawr College, Pa. 

The speaker found that work in direct systems of artificial illumina- 
tion is accompanied by a rapid fall in ocular efficiency; that in the 
semidirect system, where a part of the light falls directly on the work 
and a part is reflected from the ceiling and walls, the loss of ocular 
efficiency is nearly the same as that produced by direct illumination; 
while with indirect illumination, where no light falls directly upon 
the work, but all is reflected from ceilings and walls, the loss of ocular 
efficiency is hardly greater than with the use of diffuse daylight 
illumination. 

Intestinal Parasites in Children. 

Of interest in the session devoted to "The exciting and contributing 
causes of disease and physical defects in school children" was a paper 
read by Dr. J. A. Ferrell, of the Rockefeller Sanitary Commission, 
on "Intestinal parasites, the rural school a factor in spreading their 
infection." 

This paper gave a summary of the findings of the commission in 
the case of 46,794 children found harboring intestinal parasites. Of 
these, 22,782, or 48 per cent, had hookworm infection; 7,991, or 20 per 
cent, had ascarides; 2,915, or 6 per cent, had Trichocephalus dispar; 
1,246, or 2 per cent, had dwarf tapeworm; 134, or 0.2 per cent, had 
strongyloides; and 46, or 0.09 per cent, had Oxyuris vermicularis. 

Of interest is Dr. Ferrell's statement that many of the cases of 
ascaris infection presented marked symptoms of retardation and 
anemia. 

o 



